Subclinical exocrine pancreatic insufficiency in dogs.
J Am Vet Med Assoc
; 220(8): 1183-7, 2002 Apr 15.
Article
em En
| MEDLINE
| ID: mdl-11990965
ABSTRACT
OBJECTIVE:
To study progression of autoimmune-mediated atrophic lymphocytic pancreatitis from the subclinical to the clinical phase (exocrine pancreatic insufficiency [EPI]) and determine whether progression of the disease could be halted by treatment with immunosuppressive drugs.DESIGN:
Randomized controlled trial. ANIMALS 20 dogs with subclinical EPI. PROCEDURE Diagnosis of subclinical EPI was determined on the basis of repeatedly low serum trypsin like-immunoreactivity (TLI) in dogs with no signs of EPI. Laparotomy was performed on 12 dogs with partial acinar atrophy and atrophic lymphocytic pancreatitis. A treatment group (7 dogs) received an immunosuppressive drug (azathioprine) for 9 to 18 months, and a nontreatment group (13) received no medication.RESULTS:
During the subclinical phase, serum TLI was repeatedly low (< 5.0 microg/L). Although a few dogs had nonspecific gastrointestinal tract signs, they did not need diet supplementation with enzymes. While receiving immunosuppressive medication, treated dogs had no clinical signs of EPI, but within 2 to 6 months after treatment was stopped, 2 dogs had signs of EPI, and diet supplementation with enzymes was started. Five of the 13 untreated dogs needed diet supplementation with enzymes within 6 to 46 months. During follow-up of 1 to 6 years, 3 of the 7 treated dogs and 8 of the 13 untreated dogs did not need continuous diet supplementation with enzymes. CONCLUSIONS AND CLINICAL RELEVANCE Progression of atrophic lymphocytic pancreatitis varied widely. The subclinical phase may last for years and sometimes for life. The value of early treatment with an immunosuppressive drug was questionable and, because of the slow natural progression of the disease, cannot be recommended.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Insuficiência Pancreática Exócrina
/
Doenças do Cão
/
Terapia Enzimática
/
Imunossupressores
Limite:
Animals
Idioma:
En
Revista:
J Am Vet Med Assoc
Ano de publicação:
2002
Tipo de documento:
Article
País de afiliação:
Finlândia